Bone plate for reducing angular bone deformity and method of using

Abstract

Described herein are methods and devices for the correction and reduction of bone deformities, such as metatarsus primus adductus, using a tethering technique which does not require drilling into the stable bone. In some embodiments, a bone plate has an elongate plate body and wings extending laterally from the plate body. The wings may be configured to generally follow the circumferential contours of the bone when placed on the bone in use. The bone plate can further include means for positioning cerclage material on the bone plate such that the cerclage material extends circumferentially over the wings rather than on the bone, thereby reducing the total contact area between the cerclage material and the bone.

What is claimed is: 
     
       1. A device for treating an angular bone deformity, comprising:
 an elongate plate body configured to extend along a length of a patient's stable metatarsal, the elongate plate body comprising an inner surface configured to engage the stable metatarsal and an outer surface, wherein the elongate plate body comprises a first end and a second end and a longitudinal axis extending between the first end and the second end, wherein the longitudinal axis is configured to be parallel or substantially parallel with the length of the stable metatarsal; 
 two buttress wings extending from opposite sides of the plate body, each of the buttress wings comprising an inner surface configured to engage the stable metatarsal and an outer surface, wherein the inner surfaces of the buttress wings at least partially face each other so that when the plate body and the buttress wings are placed against the stable metatarsal, the stable metatarsal is at least partially surrounded by the elongate plate body and the two buttress wings; and 
 a transverse opening located between the first and second ends of the plate body, wherein the transverse opening extends perpendicular to the longitudinal axis and is aligned with the two buttress wings such that when the plate body and the two buttress wings are placed against the stable metatarsal and cerclage material passes through the transverse opening and is tied around the stable metatarsal, and is then secured to the patient's unstable metatarsal, the cerclage material extends over the two buttress wings; 
 wherein raised ridges or flanges are disposed along the buttress wings, and a groove is disposed within a center of the wings, such that a thickness of outer edges of the buttress wings measured between the outer surface and the inner surface is greater than a thickness of portions of the buttress wings in the center of the wings, the raised ridges or the flanges or the groove being configured to maintain the position of the cerclage material centered over the wings after the cerclage material passes through the transverse opening. 
 
     
     
       2. The device of  claim 1 , wherein the plate body and the two buttress wings have inner surfaces that are flat. 
     
     
       3. The device of  claim 1 , wherein the plate body and the two buttress wings have inner surfaces that are concave and outer surfaces that are convex. 
     
     
       4. The device of  claim 1 , further comprising one or more holes in the plate body or the two buttress wings. 
     
     
       5. The device of  claim 1 , wherein the transverse opening is centrally located between the first end and the second end of the plate body. 
     
     
       6. The device of  claim 1 , wherein the transverse opening is defined at least in part by a dorsal loop provided on or above the outer surface of the plate body. 
     
     
       7. The device of  claim 6 , wherein the dorsal loop comprises a curved wall extending above the outer surface of the plate body. 
     
     
       8. The device of  claim 6 , wherein the dorsal loop comprises a flat wall extending above the outer surface of the plate body. 
     
     
       9. The device of  claim 6 , wherein the plate body comprises a hole between the first end and the second end beneath the dorsal loop. 
     
     
       10. The device of  claim 6 , wherein the dorsal loop is fixed and immobile relative to the plate body. 
     
     
       11. The device of  claim 6 , wherein the plate body, the two buttress wings and the dorsal loop are integrally formed from a single piece of material. 
     
     
       12. The device of  claim 1 , wherein the two buttress wings are symmetrically positioned about the longitudinal axis. 
     
     
       13. The device of  claim 1 , wherein the two buttress wings are centrally located between the first and second ends of the plate body. 
     
     
       14. The device of  claim 1 , wherein a longitudinal length of each of the buttress wings is shorter than a longitudinal length of the plate body between the first end and the second end. 
     
     
       15. The device of  claim 1 , comprising multiple pairs of buttress wings longitudinally spaced along the length of the plate body. 
     
     
       16. The device of  claim 1 , wherein the buttress wings are configured to prevent cerclage material from directly contacting the stable metatarsal when cerclage material extends through the transverse opening to fix the free ends of the cerclage material to the patient's unstable metatarsal. 
     
     
       17. The device of  claim 1 , wherein each of the buttress wings extends outwardly away from the longitudinal axis. 
     
     
       18. The device of  claim 1 , wherein each of the buttress wings extends in a direction perpendicular or generally perpendicular to the longitudinal axis. 
     
     
       19. The device of  claim 1 , wherein the plate body comprises first and second lateral sides extending parallel or substantially parallel with the longitudinal axis, wherein a first of the two buttress wings extends away from the first lateral side and a second of the two buttress wings extends away from the second lateral side. 
     
     
       20. The device of  claim 1 , wherein the two buttress wings are configured to engage opposite sides of the stable metatarsal. 
     
     
       21. The device of  claim 1 , wherein the plate body is configured to engage a lateral side of the stable metatarsal and be fixed relative thereto without drilling a hole in the stable metatarsal. 
     
     
       22. The device of  claim 1 , wherein the plate body and the two buttress wings are configured to at least partially surround the second metatarsal. 
     
     
       23. A system for treating an angular bone deformity, comprising the device of  claim 1 , and further comprising cerclage material configured to extend through the transverse opening and configured to fix the stable metatarsal relative to the unstable metatarsal. 
     
     
       24. The system of  claim 23 , further comprising one or more screws configured to fix the cerclage material to the unstable metatarsal. 
     
     
       25. The system of  claim 23 , further comprising a suture passing instrument.